Electrosurgical generators have various control devices located on a front control panel to permit the user to select different functions of the generator and to select and adjust output power characteristics of the generator. For instance, the mode of operation of the generator is selected by manipulating selector switches or buttons to cut tissue, to coagulate blood flow from the tissue, or to cut and coagulate simultaneously in a monopolar mode of operation. A bipolar mode of operation is used primarily for coagulation of blood flow. In addition, after selecting the mode of operation, the output power characteristics may be selected by manipulating other selected switches or buttons. In some modes of operation, such as simultaneous cutting and coagulation, the characteristics of the output power delivered may further be selected and adjusted from front panel control devices. Other functionality of the generator is also obtained by manipulating other types of front panel control devices.
The front panel control devices of the electrosurgical generator cannot be positioned within the sterile field where the surgeon is operating because it is not possible to disinfect and sterilize the entire electrosurgical generator of which the front panel control devices are a part. Typical front panel control devices are complex structures with movable components and other intricate mechanical and electrical parts. The complex nature of these control devices does not permit disinfectant solutions from penetrating into their inner regions, and thus sterilization cannot be achieved. Moreover, a somewhat intricate and delicate nature of these control devices are not sufficient to withstand high temperature sterilization.
A typical front control panel for electrosurgical generator also has displays for displaying information concerning the functionality of the generator, such as the selected mode of operation and amount of output power delivered. Such displays are also not capable of being sterilized, either by a disinfectant solution or by the application of heat, for the same reasons that the front panel control devices cannot be sterilized.
During the course of a typical surgical procedure, it is necessary to adjust the mode of operation and the output power characteristics of the electrosurgical generator. Some types of surgical procedures require almost constant adjustments. The surgeon performing the procedure determines what adjustments must be made and when to make them. Because the electrosurgical generator, including the front panel controls, cannot be sterilized, the electrosurgical generator must remain outside of the sterile field surrounding the surgical site where the surgeon is performing the procedure. Because adjustments must be made during the course of the procedure, the surgeon must rely on an assistant to make adjustments. The assistant must remain outside of the sterile field, because the assistant is interacting with the non-sterile front control panel of the electrosurgical generator.
The assistant makes adjustments to the front panel control devices in response to verbal commands from the surgeon. Such verbal communication may be prone to misinterpretation, and the changes in operating characteristics of the electrosurgical generator may not be made as quickly as the surgeon may desire, due to the fact that the assistant may not be responsive at the time of the verbal command because of other responsibilities in the operating room. In any event, the necessity to rely on an assistant to control the electrosurgical generator can become a source of distraction or frustration to the surgeon, particularly in intense procedures which require numerous adjustments during the course of the procedure. However, the requirement for a sterile field around the surgical site necessitates such indirect control techniques.
In a similar sense, the surgeon must rely on the assistant to communicate power settings and other information describing the functionality of the generator, because the generator is located outside of the sterile field. While it is possible for the surgeon to divert his or her attention from the surgical site to view the displays of information presented on the front panel of the generator, such movement is a distraction. Moreover, the electrosurgical generator must be placed outside of the sterile field but within eyesight of the surgeon, if the surgeon is to view information displayed on the front panel of the electrosurgical generator. In many circumstances, it is impossible for the electrosurgical generator to be placed so that it could be directly viewed by the surgeon.
The electrosurgical generator is typically located in the operating room close to the operating table since the electrical conductors must extend from the electrosurgical generator to a handpiece held by the surgeon to apply the electrical energy to the patient. The front panel of the electrosurgical generator must be accessible to an assistant so that the surgeon's verbally commanded selections and adjustments can be made. Locating the generator to accommodate these requirements means that the generator is usually positioned on a cart relatively close to the operating table. Positioned in this manner, the electrosurgical generator takes up valuable space around the operating table. A number of people are usually present in the operating room and surround the operating table during the course of the procedure, particularly in complex procedures. The necessity to locate the electrosurgical generator relatively close to the operating table diminishes the amount of space available for surgeons and assistants surrounding the patient and adds to the congestion during the procedure.
One approach to controlling the electrosurgical generator utilizes a holograph to project an image of the controls into empty three-dimensional space within the operating room. When an object enters the three-dimensional space in which the holographic image of the controls is located, an adjustment to the generator is made. Allowing the surgeon to interact with a holographic image allows the surgeon to establish direct control over the surgical equipment without compromising the sterile field. However, holographic images introduce new problems. One such problem stems from the fact that holographic images can only be viewed from a relatively narrow field of vision, which means that the holographic image may not always be seen by the surgeon. For the surgeon to view the holographic controls, the light projection equipment that creates the hologram has to be adjusted in a particular location in the operating room, or the surgeon must shift his or her position at the operating table, or the surgeon must again rely on an assistant to interact with the hologram to achieve control over the surgical equipment. Moreover, because the hologram exists in three-dimensional space, an individual or object can inadvertently move through the three-dimensional space and interact with the hologram in such a way to create an unintended adjustment of or control over the electrosurgical generator. This is especially the case if the hologram is placed near the surgical site where there is much activity during surgery. Furthermore, because the hologram is placed in space away from the surgical site, the surgeon must look up or turn to see and interact with the hologram, which is inconvenient and distracting for the surgeon and can interfere with the surgeon's concentration.
The control and display devices are physically located in fixed positions on the front panel of the electrosurgical generator during its manufacture. The physical position of these control and display cannot thereafter be changed to accommodate any preferences for organization, layout, and presentation. Also, if the functionality of the electrosurgical generator is upgraded, the new functionality must operate with the existing arrangement of front panel control and display devices. Therefore, the fixed configuration of the front panel control and display devices serves as a limitation on the ability of the surgeon or the surgical personnel to organize and control the electrosurgical generator for optimum use and convenience, and also limits the opportunities to upgrade or change the operating characteristics of the electrosurgical generator.